Sunday, June 13, 2010

So Scots have a death wish?

We’re doomed. Doomed. Get out now while you still can. It’s a wonder there’s anyone left in Scotland so terrifying are the headlines about Scottish mortality. 97% of us are living dangerously unhealthy lives according to a report last week in BMC Public Health. A boy born in Glasgow can expect to live thirteen years less than a boy born in Chelsea, according to the Office of National Statistics. Twice as many of us die from alcohol abuse than in England - that’s if we aren’t murdered first. Half a million of us have coronary heart disease, according to CHASS - one of the highest rates in the world. Diseases like multiple sclerosis are off the scale. Two thirds of us are overweight or obese.

What’s the point of spending £2,000 a year on the Scottish NHS, 16% more than in England, when Scots are popping their clogs so fast the undertakers have to wear running shoes? Researchers at the Centre for Public Policy in the Regions last week questioned the wisdom of throwing £10 billion a year at self-destructive Scots - a figure that has doubled in a decade. Scottish health is not improving in line with other countries. Indeed, in ten years, our mortality from supposedly preventable diseases will be worse than the worst regions of Eastern Europe like Silesia, so fast are we slipping behind Europe in tackling the great killer diseases.

Is it the weather? Genetics? Or do we just have a collective death wish? I must say that, as one of the 3% who actually did look after myself in all the ways the other 97% of Scots apparently do not, I have had particular cause to ask these questions. I still developed coronary heart disease even though I didn’t smoke, took exercise, ate properly and drank in moderation. Which was a bitch, and made me want my money back. But the worst of it is that one really seems to know why Scots are so prone to life threatening disease.

Dr David Conway, the author of last week’s “shock” BMC Public Health report on our fondness for live-threatening behaviours asks whether there could indeed by a “Scottish effect” - a pyscho-cultural factor at work in Scottish communities. Professor Phil Hanlon of Glasgow University thinks it’s more like a “Glasgow effect”. How else to explain why between 2004 and 2007, there were 60% more deaths in Glasgow than in comparably “deprived” cities like Liverpool and Manchester? If you take the Strathclyde constituencies out of the picture, the rest of Scotland is very much like England in terms of life expectancy and heart disease. Yet, in the worst areas of social deprivation like Glasgow Springburn life expectancy for men is 57 and for women, 61. It’s a bitter paradox that Glasgow is also one of the most vibrant in Europe in terms of youth culture, the creative industries and even retail.

Prof Hanlon believes that rather than just spending more we might be better looking at ways of making Scots more positive and sociable in their outlook. Anecdotally we know all the manifold ways in which Scottish male culture is injurious to mental and physical well-being. The way we attack alcohol certainly looks like a symptom of some deeper psychological disturbance. It goes without saying that Scottish men - of my generation certainly - have great difficulty talking about their feelings and are pretty neglectful of their personal well-being. When Scottish men get together in drink they generally start “flyting” or ritually abusing each other. Behind the braggadocio, Scottish men are cripplingly insecure. Our gift for wry cynicism makes it almost impossible to benefit from therapies like Cognitive Behaviour Therapy or positive thinking - positive drinking more like.

Maybe it’s history. Since the loss of political autonomy three hundred years ago, Scotland has exported many of its more optimistic citizens. Highlanders were cleared from the land to make Scotland a Victorian theme park for the English aristocracy. The lowlands became a source of cheap labour to fuel the industrial revolution. But the flip-side is that neo-nationalist whinge is that Scotland was one of the leading countries in the European Enlightenment in the 18th Century with the best education system in the world. During the industrial age we were the workshop of the world designing and manufacturing the most advanced engineering in history. Subordination to England isn’t any kind of explanation.

But there are broader political considerations. It’s no accident that most of the dire statistics on health, heart disease and alcohol abuse really got underway in the 1980s when the great industrial recessions destroyed the manufacturing way of life. The collapse of the self-confident working class communities left a legacy of mental inactivity, hopelessness, ill health. Families broke up as men became redundant. 200,000 people of working age left languishing on benefits. Drugs invaded these once resilient communities like dry rot. Cheap alcohol provided an easy anaesthetic for generations of Scottish men who simply had no purpose in life.

Whose fault? I don’t know. Certainly Scotland has been criminally let down by its political leadership at local and national level. The Tories never understood Scotland and Labour, dug into its bureaucratic one-party local states, seemed content to defend the benefits culture. Devolution has made a difference, and the smoking ban was a huge step forward. But even now brain dead oppositionism and factionalism has prevented action on minimum pricing of alcohol - a policy universally supported by the police, doctors, public health experts and churches. Incredibly, minimum pricing is now likely to happen in England first. This is junk politics by MSPs who have no sense of moral priorities.

The reality is that most of Scotland’s health problems are not psychological but historial - a product of economic and social malaise. They arise from poor education, bad housing, social and economic decay. The good news is that Scotland's health problem can be solved, just as they have been solved in other Nordic countries. Alcohol abuse could be eliminated in a decade, just asin Finland, Sweden where a pint costs eight quid. Suitable tax powers and a smaller more dynamic state could generate economic activity and get the nation working again. We know how to tackle the Scottish disease and the elements are there - all we need is the political will.

And here’s a final thought: that figure of 97% of Scots indulging in self-destructive behaviour is just the same in England.

7 comments:

And as a supporter of the Union with England you seem quite happy to see Scotland go on this way for another 300 years. The Scots parliament needs to take complete control of its affairs then Scots may then change there mind set and take responsibility for there own affairs,no more blaming England and Westminster.

So, what are you saying Iain? - that the SNP is pursuing a logical and principled policy that will benefit Scotland and that Labour, the Lib Dems and the Tories are playing fast and loose with our well-being for the sake of political advantage?Is that what you're saying Iain?Well, fu**ing-well say it then!Name the guilty parties, spread their infamy on the pages of our newspapers, point the finger!Or just post a wee blog on t'internet that's coy about the culpability of LABLIBCON and have a wee dig about nationalist whingeing in there for good measure.

I think its a very fair article although I don't think MS belongs in the list presented as those who suffer it are innocents unlike those who do damage to themselves through cigarettes and alcohol. Scotland's MS statistics are truly shocking but the real shock is that if such statistics were related to the London area research into the cause would have found answers long before now. Instead MS sufferers have to rely on Charities to help them.

As for naming names, does Iain have to do that? We know who voted against minimum pricing. Labour and the Tories did and the Lib-Dems abstained. We know who they are.

And Iain is one of the few left at the Herald who in my view speaks the truth mostly. He was warning about the crash looming long before the rest of us realised just how bad it was going to be.

I can see the connection between lost industries, towns and cities now not just on their knees but on their bellies and the sense of hopelessness that leads people to lose the nightmare in booze. When I was 16 there were choices, there were options. Now options are few if there are any at all.

But there is the other side too: there are those who drink to excess without a thought for the consequences. There are those who have no prospects, no money and who are happy to take the welfare route from their teens. Those people are mainly young women with young children who are doomed from the moment they are born. There are third and fourth generation "families" who have never had a father figure present at any time. There are daft wee lassies, barely children themselves, pushing weans about in prams and who can't even be bothered connecting with those children because they're too busy texting. There are babies who will grow up with a succession of one-night stands who need to hope they don't upset the latest boyfriend and get battered as a result while the mother looks on and does nothing because she "loves" him.

So yes, there are many good reasons for the present sorry state of affairs but mainly I think we, as communities, as families and as a society have totally lost the plot. Jo

About Me

Iain Macwhirter is the award-winning political columnist for the Herald and Sunday Herald. He has been a political broadcaster for over 20 years, in Westminster and Holyrood, and is former Rector of Edinburgh University.